AlF-NOTA-HER2-BCH与F-FDG PET/CT在评估新诊断的HER2低表达乳腺癌患者中的比较
AlF-NOTA-HER2-BCH versus F-FDG PET/CT in evaluating newly diagnosed HER2-low breast cancer patients.
作者信息
Guo Xiaoyi, Liang Xu, Li Ben, Mao Yan, Zhou Nina, Liu Jiayue, Yang Guangjie, Wang Zhenguang, Song Guohong, Yang Zhi
机构信息
Key laboratory of Carcinogenesis and Translational Research (Ministry of Education), Beijing Key Laboratory of Research, Investigation and Evaluation of Radiopharmaceuticals, NMPA Key Laboratory for Research and Evaluation of Radiopharmaceuticals (National Medical Products Administration), Department of Nuclear Medicine, Peking University Cancer Hospital & Institute, Beijing, China.
Department of Breast Oncology, Peking University Cancer Hospital & Institute, Beijing, China.
出版信息
Eur J Nucl Med Mol Imaging. 2025 Apr 10. doi: 10.1007/s00259-025-07251-w.
PURPOSE
To assess the diagnostic performance and the whole-body heterogeneity of HER2 expression on AlF-NOTA-HER2-BCH PET/CT in patients with HER2-low breast cancer.
METHODS
In this prospective study conducted from November 2021 to March 2024, participants with HER2-low breast cancer underwent both AlF-NOTA-HER2-BCH and F-FDG PET/CT. Participants were pathologically confirmed as HER2-low (immunohistochemistry score of 1 + or 2 + without HER2 gene amplification on in situ hybridization). PET/CT images were acquired 3.5 h after injection of 200 MBq of AlF-NOTA-HER2-BCH. The maximum standardized uptake value (SUVmax) and target-to-background ratios (TBR) were used to quantify tracer uptake.
RESULTS
Fifty-two participants with HER2-low breast cancer (mean age, 53.0 ± 11.0; 52 females) underwent AlF-NOTA-HER2-BCH and F-FDG PET/CT with paired tumor biopsies. No adverse events occurred. The median SUVmax and TBR of 52 HER2-low biopsy lesions on AlF-NOTA-HER2-BCH PET/CT were lower than that on F-FDG PET/CT (6.6 vs. 10.5, P <.001; 8.0 vs. 10.6, P =.009). A total of 269 suspicious lesions were detected, F-FDG PET/CT depicted more suspected HER2-low positive lesions in breast (100% vs. 100%), chest wall (100% vs. 100%), lymph node (83.9% vs. 77.7%), bone (100% vs. 93.2%), liver (66.7% vs. 52.4%) and lung (86.7% vs. 75.0%) than AlF-NOTA-HER2-BCH PET/CT. Additionally, clear interindividual and intraindividual differences on AlF-NOTA-HER2-BCH tracer uptake was noted between participants, between different metastases in the same participants, even within different organ systems.
CONCLUSION
The visualization of HER2-low breast cancer with AlF-NOTA-HER2-BCH PET/CT was feasible and safe. The observed intra- and inter-individual heterogeneity in the uptake of AlF-NOTA-HER2-BCH indicates its potential use as a noninvasive tool for assessing disease heterogeneity and identifying patients who may derive clinical benefit from HER2-targeted therapies.
目的
评估AlF-NOTA-HER2-BCH PET/CT对HER2低表达乳腺癌患者的诊断性能及全身异质性。
方法
在2021年11月至2024年3月进行的这项前瞻性研究中，HER2低表达乳腺癌患者同时接受了AlF-NOTA-HER2-BCH和F-FDG PET/CT检查。患者经病理确诊为HER2低表达（免疫组化评分为1+或2+，原位杂交检测无HER2基因扩增）。注射200 MBq的AlF-NOTA-HER2-BCH后3.5小时采集PET/CT图像。采用最大标准化摄取值（SUVmax）和靶本比（TBR）对示踪剂摄取进行量化。
结果
52例HER2低表达乳腺癌患者（平均年龄53.0±11.0岁；52例女性）接受了AlF-NOTA-HER2-BCH和F-FDG PET/CT检查及配对肿瘤活检。未发生不良事件。AlF-NOTA-HER2-BCH PET/CT上52个HER2低表达活检病灶的SUVmax和TBR中位数低于F-FDG PET/CT（6.6对10.5，P<.001；8.0对10.6，P=.009）。共检测到269个可疑病灶，F-FDG PET/CT在乳腺（100%对100%）、胸壁（100%对100%）、淋巴结（83.9%对77.7%）、骨（100%对93.2%）、肝（66.7%对52.4%）和肺（86.7%对75.0%）中发现的HER2低表达阳性可疑病灶比AlF-NOTA-HER2-BCH PET/CT更多。此外，在参与者之间、同一参与者的不同转移灶之间，甚至在不同器官系统内，均观察到AlF-NOTA-HER2-BCH示踪剂摄取存在明显的个体间和个体内差异。
结论
AlF-NOTA-HER2-BCH PET/CT对HER2低表达乳腺癌的可视化是可行且安全的。观察到的AlF-NOTA-HER2-BCH摄取的个体内和个体间异质性表明其有可能作为一种无创工具，用于评估疾病异质性并识别可能从HER2靶向治疗中获益的患者。
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